糖尿病白内障患者超声乳化吸除术后泪膜的早期改变  

Early changes in the tear film of diabetics after phacoemulsification

作　　者：马晓华[1] 毕宏生[1] 解孝锋[1] 李海燕[1] 陈树悦[1] 钱大伟[1] 

机构地区：[1]济南施尔明眼科医院,山东济南250002

出　　处：《眼视光学杂志》2005年第3期166-168,共3页Chinese Journal of Optometry & Ophthalmology

摘　　要：目的探讨糖尿病白内障患者超声乳化吸除术后早期泪膜的改变。方法随机选择30例(38只眼)行白内障超声乳化吸除术的糖尿病白内障患者,观察分析术前、术后第1天、第1周、第1个月、第3个月的主观感觉、荧光素试验、泪膜破裂时间(break-up time,BUT)、基础泪液分泌试验(schirmerⅠtest,SⅠt)及干眼仪检查情况。结果与术前相比,术后第1天、第1周、第1个月干燥异物感加重,术眼BUT明显缩短,干眼仪检查等级明显增高,差异有显著性(P<0.05),术后第3个月接近术前水平,差异无显著性(P>0.05)。术后第1天、第1周角膜荧光素着色点明显增多,差异有显著性(P<0.05)。术后第1个月、第3个月接近术前水平,差异无显著性(P>0.05)。术后第1天泪液分泌量明显增多,差异有显著性(P<0.05)。术后第1周、第1个月、第3个月接近术前水平,差异无显著性(P>0.05)。术后第1个月时,角膜荧光素染色>2分、BUT<5 s的发生率随糖尿病病程的延长而增高,差异有显著性(P<0.05)。BUT<5 s的发生率女性高于男性,差异有显著性(P<0.05)。BUT与年龄呈轻度负相关(r=-0.45,P<0.05)。结论糖尿病白内障患者超声乳化吸除术后早期可出现泪膜的异常改变,尤其表现为泪膜稳定性下降,是干眼症的易患人群,以老年、女性、糖尿病病程长者为甚。Objective To study early changes in the tear film of diabetics after phacoemulsification.Methods Thirty-eight eyes of 30 patients with diabetic cataract who had undergone phacoemulsification were randomly selected. The evaluation included subjective complaints of dry eye, tear break-up time, corneal fluorescein staining, and tear film pattearn. A DR-1 tear interferometry and Sehirmer I test （S I t） were used to assess values befrore .surgery and 1 day, 1 week, 1 month and 3 months postoperatively. Results Subjective complaints of dry eye and the. grades of tear film pattern increased significantly while the mean tear break-up time was greatly reduced at 1 day, 1 week and 1 month postoperatively （P〈0.05）. However, all values recovered to preoperative levels by the time of the 3 month follow-up visit （ P 〉 0.05 ）. Corneal fluorescein staining scores increased significantly when measured at the 1 day and 1 wee.k visits （ P 〈 0.05） but had returned to preoperative values by the 1 month and 3 month visits （P 〉 0.05 ）. The mean S I t value in- creased significantly at 1 clay postoperatively （P 〈 0.05） but retnrned to the preoperative value at 1 week. The grades ard the. amount of time. that signs of dry eye lasted were higher in females and we.re related to both age. and a longer history of diabetes. Conclusion Tear film in diabetics may have abnormal changes, mainly in tear stability, during the early stages after phacoemulsification.

关 键 词：糖尿病 超声乳化术/方法 白内障/外科手术 泪膜 干眼症 泪膜破裂时间 

分 类 号：R779.66[医药卫生—眼科]